Clinical Characteristics, Exercise Capacity and Pulmonary Function in Post-COVID-19 Competitive Athletes

Abstract

Background: Limited evidence exists regarding adverse modifications affecting cardiovascular and pulmonary function in physical active adults affected by COVID-19, especially in athletic populations. We aimed to describe the clinical presentation of COVID-19 in a cohort of competitive athletes, as well as spirometry and echocardiography findings and cardio-respiratory performance during exercise. Methods: Twenty-four competitive athletes with COVID-19 were recruited for this study after ending self-isolation and confirmation of negative laboratory results. All athletes underwent clinical evaluation, spirometry, echocardiography and cardiopulmonary exercise testing (CPET). These data were compared to a group of healthy control athletes. Results: Anosmia was the most frequent symptom present in 70.83% patients, followed by myalgia, fatigue and ageusia. The most frequent persisting symptoms were anosmia 11 (45.83%) and ageusia 8 (33.33%). Compared to controls, COVID-19 patients presented lower FEV1%: 97.5 (91.5–108) vs. 109 (106–116) p = 0.007. Peak Oxygen Uptake (VO2) in COVID-19 patients was 50.1 (47.7–51.65) vs. 49 (44.2–52.6) in controls (p = 0.618). Conclusions: Reduced exercise capacity was not identified and pulmonary and cardiovascular function are not impaired during early recovery phase in a population of physical active adults except FEV1 reduction.

COVID‐19 disease in professional football players: symptoms and impact on pulmonary function and metabolic power during matches

“…Moreover, no association between days of infection and ΔFVC, ΔFEV 1 , ΔFEV 1 /FVC, and ΔPEF was observed, even though the small sample size tested ( n = 10) and a narrow range of both dependent and independent variables may have hindered some associations. These findings suggest that COVID‐19 does not considerably affect FVC, FEV 1 , FEV 1 /FVC, and PEF in athletes with mild symptoms, which is in line with previous investigations (Fikenzer et al, 2021 ; Milovancev et al, 2021 ), but in contrast with others (Gervasi et al, 2021 ; Komici et al, 2021 ). No evidence of spirometric impairments was also observed in a large cohort of healthy young adults who had mild‐to‐moderate COVID‐19 symptoms (Mogensen et al, 2022 ), suggesting that spirometric impairments would unlikely occur in young and healthy populations.…”

“…There is limited and contradictory data on the effect of COVID‐19 on pulmonary function in the athletes population. Specifically, some studies have reported impairments in some of the spirometry measures tested following COVID‐19 (Fikenzer et al, 2021 ; Komici et al, 2021 ; Milovancev et al, 2021 ), while others have not (Gervasi et al, 2021 ; Komici et al, 2021 ). Different factors may have accounted for such discrepancies including, different types of research design used and athletes’ fitness level (Fikenzer et al, 2021 ; Gervasi et al, 2021 ; Komici et al, 2021 ; Milovancev et al, 2021 ).…”

“…Specifically, some studies have reported impairments in some of the spirometry measures tested following COVID‐19 (Fikenzer et al, 2021 ; Komici et al, 2021 ; Milovancev et al, 2021 ), while others have not (Gervasi et al, 2021 ; Komici et al, 2021 ). Different factors may have accounted for such discrepancies including, different types of research design used and athletes’ fitness level (Fikenzer et al, 2021 ; Gervasi et al, 2021 ; Komici et al, 2021 ; Milovancev et al, 2021 ). It is also worth noting that it is still unclear whether spirometry tests may be of prognostic value or should be used as predictors of respiratory symptoms following COVID‐19 in athletes.…”

Diagnostic evaluation and cardiopulmonary exercise test findings in young athletes with persistent symptoms following COVID-19

“…Therefore, we cannot delineate if the higher prevalence of abnormal spirometry in post-COVID as compared with reference athletes was due to COVID-19 or reflects baseline differences between the groups despite careful matching. Others have reported mild decreases in FEV 1 in athlete cohorts that were not selected for persistent symptoms as compared with pre-COVID values 15 or controls, 16 which support the possibility that the observed spirometry abnormalities in our study were due to COVID-19. Given incomplete longitudinal improvement, our study may have been enriched for athletes with mild baseline spirometry abnormalities, and future work should identify if such athletes are at higher risk of developing persistent cardiopulmonary symptoms after COVID-19 or if this represents a limitation of our small cohort size.…”

“…Despite the presence of prominent symptoms, most athletes in our cohort did not demonstrate significant abnormalities of ventilatory efficiency or pVO 2 on their first CPET, which is consistent with others’ results in variably symptomatic athletes. 16 17 20 22 Conversely, we observed a high proportion of post-COVID athletes with mild abnormalities in screening spirometry. Our study is limited in that baseline pre-COVID spirometry was not available and, with a focus on ruling out cardiac disease, full and appropriately customised pulmonary evaluation was not systematically performed.…”